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Employers try integrated approach

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BOSTON--Southern California Edison Co. looked to improve its delivery of employee behavioral health services after absence data showed psychosocial problems often compound physical ailments that led disability claimants to miss work.

It did so through a recent pilot program that integrated behavioral health assistance with SCE's disability and absence management offerings. SCE launched the behavioral health outreach effort after having a well-established disability program in place, said Deborah L. Jacobs, manager of disability management for Rosemead, Calif.-based electricity provider.

In contrast, Washington Mutual Inc. last year began integrating short-term disability and absence management programs after it already had health management programs in place, speakers told the Disability Management Employer Coalition's annual conference in Boston July 15-18.

It would have been easier to integrate health management services after establishing a disability program, but WaMu didn't have a short-term disability program prior to Jan. 1, said Pamela Bogner, WaMu's assistant vp and manager of integrated disability programs.

The contrasting experiences of SCE and WaMu show that employers can take different routes to successfully integrate their absence, disability and health management offerings, said Bryon E. Bass, vp and absence practice leader for Sedgwick Claims Management Services Inc. in Memphis, Tenn.

Surveys show that companies integrating the three areas experience fewer and shorter duration absences. They also experience reduced workers comp and short-term disability costs, Mr. Bass said.

But successful integration requires employers to direct employees to the help they need by determining what life circumstances should trigger outreach from employers' health and absence programs.

Employers must also push their health and disability management providers to cooperate with each other, because no one vendor is an expert in all areas of health and disability management, the speakers said.

"I wouldn't expect that (each provider) would be experts in all of these things," Mr. Bass said. "We need to learn how to work together with vendors and what protocols and triggers will get employees to the resources they need."

WaMu's integration efforts include a Web-based benefit delivery site that all providers must contractually agree to support. The portal allows employees to access health risk assessments, wellness programs, health plan comparison tools and other offerings from WaMu.

The Seattle-based financial services company also utilizes a "health advocate team" that interacts telephonically with employees and their physicians.

When an employee calls to apply for short-term disability benefits, for example, the health advocate team might refer the worker to resources such as a healthy pregnancy program or a work/life program that helps with, say, services for caring for an elderly parent.

Meeting needs boosts ROI

The approach keeps employee needs central in WaMu's integration efforts while working through a single point of contact and providing a positive return on investment, Ms. Bogner said.

SCE's pilot behavioral health services effort required a mental health and employee assistance program provider to train examiners working for the claims administrator with which SCE contracts.

That way claims examiners can recognize triggers to referring claimants to the company's EAP program, Ms. Jacobs said. SCE's efforts include an outreach program staffed with return-to-work job coaches.

Their efforts get triggered depending on a number of employee circumstances. For instance, it could be used for employees that have missed more than 90 days of work but are likely to return within 30 days.

That helps because SCE was finding that many disability claimants that return to work are soon out again because of compounding psychosocial issues, Ms. Jacobs said.

As one example of how the job coach has helped, Ms. Jacobs told of a meter reader who claimed she was disabled following childbirth. The coach learned, however, that the meter reader was a victim of domestic violence with four children and had recently left a shelter for another unstable living arrangement. The coach helped the woman to find legal and financial assistance, and counseling for her and her children along with other services. She also was placed in a new position at SCE.